The British Medical Association has taken at Southport an important decision which has passed with little comment. It is to set up a committee to draft "a reasoned programme" of reforms in the National Health Service. If this committee is of the same calibre as the one which has produced the reports on medical training in general and on the training of general practitioners in particular, its suggestions will be worth more than any amount of sound and fury about the iniquity of the Minister and the frivolity of patients.

It is plain that the Health Service is working with a good deal of friction, as might have been expected, and that the friction has abraded the general practitioners more severely than anyone else. But a report which aimed at no more than to make things easier, or more remunerative, for the doctors – not that it would be wrong to do either – would be treating the symptoms rather than the disease.

It is what one might call the internal organs of the scheme which would be best worth exploring, to see whether, and why, the load is bearing more heavily on one part than on another and how the stresses can be readjusted. It is an inquiry, in short, which calls for the scientific approach and thoroughness and objectivity which doctors traditionally give to a problem of medical knowledge. Perhaps the move which the delegates are just about to make may be taken as a symbol of the spirit in which the committee, generated in the heat of controversy, will apply itself to its task.

This inquiry may take the doctors some way out of their own professional field, and that will not be a bad thing, for medicine does not live in a void. Some aspects of these non-medical relationships came up for discussion at Southport. It was complained, for instance, that too great a share in the running of the hospitals is given, or tends to be given, to laymen. This is not altogether an innovation; for the voluntary hospitals normally had lay boards, and the municipal hospitals worked under a corporation committee composed mainly of laymen. But perhaps the laymen are now taking more upon themselves. The proper balance of responsibility between medical and lay administrators is a problem of the first importance. A layman who does not understand or respect the conditions of good doctoring can have disastrous effects; but a good doctor may sometimes be a very poor administrator.

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